Inspection on 28/06/05 for Buchanan Court Nursing Home

This inspection was carried out on 28th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Buchanan Court Nursing Home 01/04/09

Buchanan Court Nursing Home 25/04/08

Buchanan Court Nursing Home 13/11/07

Buchanan Court Nursing Home 04/06/07

Buchanan Court Nursing Home 12/10/06

Buchanan Court Nursing Home 09/02/06

Buchanan Court Nursing Home 18/01/05

Buchanan Court Nursing Home 28/07/04

Buchanan Court Nursing Home 02/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Buchanan Court Nursing Home Buchanan Court Care Centre Sudbury Hill Harrow, Middx HA1 3AR Lead Inspector Ram Sooriah Unannounced 28 June 2005, 10:00h00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Buchanan Court Nursing Home Address Buchanan Court Care Centre Sudbury Hill Harrow Middlesex HA1 3AR 020 8423 3311 020 8423 2299 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashbourne Homes Limited CRH N Care Home with nursing 85 Category(ies) of OP Old Age 65 years and over 83 registration, with number PD Physical Disability 58 years and over 2 of places Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18/1/5 Brief Description of the Service: Buchanan Court belongs to Ashbourne Plc a national provider of care homes mainly for the elderly. The home is found in Sudbury Hill. It is easily accessible by public transport as the area is well served by buses. The closest underground station is Sudbury Hill, which is about 10 minutes walk away. There is an extensive parking area in the grounds of the home. There are maintained lawn/srubs areas in the front and at the back of the home. Buchanan Court is registered for 85 elderly service users requiring nursing care. However, only 70 beds in the home are used. It is purpose built and provides accommodation on 3 floors. The ground floor accommodates 25 service users, the first floor also has 25 beds and the second floor accommodates 20 service users. Accommodation is provided in a mixture of single and double bedrooms with en-suite facilities. The home is run by Jane Karago, the general manager and her deputy, Kamala Chohun. On the day of the inspection there were 58 service users in the home. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection started at 1000 and lasted until about 1730. This is the first of the two statutory inspections for the period 2005-2006. The inspector spoke to a number of service users, visitors and staff in the home. He looked at a sample of records, toured some of the premises and observed care practices. He then gave feedback to the manager and checked for compliance with past requirements. There has been an unannounced inspection on the 14th March 2005 in addition to the statutory annual inspections. The letter following this unannounced inspection is available upon request. The inspector would like to thank the service users, visitors, the manager and her staff for their support and cooperation during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Some areas of the home could have been cleaner. More emphasis could be given to the provision of activities in the home. Appropriate wheelchairs must be provided to service users to improve their comfort and for health and safety reasons. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 Service users did not always have records of a comprehensive assessment of their needs to demonstrate clearly that the home was aware of service users’ needs. EVIDENCE: The inspector looked at the preadmission assessment of a service user who has recently been admitted to the home. This was generally well completed. Once admitted to the home, the needs of the service users were reassessed to enable care plans to be drawn. The inspector looked at four care plans and noted that the comprehensiveness of the needs assessments was variable. One of the four assessments was comprehensive and contained clear information about the needs of the service user and about meeting these needs. Others had sections, which were not comprehensively completed. For example the sections on skin assessment, breathing, maintaining a safe environment and sleeping were not always completed. The inspector spoke to a number of service users, including a number who use the home for respite care. The service users were generally happy with the Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 9 care that they receive. The home had appropriate numbers of staff to meet the needs of service users. Conversation with the manager and her deputy suggests that the staff have also received training in a number of areas to make them skilled to look after the service users. The inspector discussed the care of service users with trained members of staff and concluded that although the assessment of needs were not always comprehensively recorded, they were aware of the needs of the service users and were aware of what needed to be done to meet these needs. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-10 The healthcare needs of service users in the home were being met. Care plans could have been more comprehensive and were not always drawn with the consultation of service users or representatives. The content of risk assessments was not always changed to reflect the changing condition of service users. Medicines management in the home was generally good but could have been more comprehensive to ensure the health and safety of service users at all times. EVIDENCE: Individual care records were available for inspection. These were generally in good order and kept at the nurse’s station. Care plans were generally in place where needs of service users have been identified. The inspector however noted that in two cases where service users had particular infections, there were no care plans in place to deal with these situations. There was a range of risk assessments in place for each service user and more specific risk assessments as required. These were mostly reviewed on a monthly basis. Plans of care were also reviewed monthly. The inspector noted that the content of the manual handling risk assessment of a service user was not changed when the condition of the service user changed, despite the entry of a date to show that the risk assessment has been reviewed. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 11 There was some evidence in care records that service users/representatives were being involved in drawing care plans. This was however not always apparent even when service users had relatives. The home had one service user who was admitted to the home with a pressure sore. There was a range of pressure relieving equipment for the care of service users with or at risk of developing pressure sores. Care plans were in place with wound assessments and photos in the case of the service user with the pressure sore. The inspector noted that incontinence assessments and care plans on incontinence were not always clear to describe the individual management of service users who were incontinent. For example the type of incontinence aids and time for changing the pads were not always made clear. There was evidence that service users were seen by the GP and other healthcare professionals as necessary. The inspector looked at medicines on the first and the second floors. Medicines were kept safety and appropriately in an air-conditioned clinical room. The inspector noted that the medicine for a service user, which was supposed to be given twice daily, was signed three times a day. It is unlikely that the medicine was given three times a day as it came in two cassettes. However this demonstrated that nurses were not always vigilant with regard to checking and signing the medicines charts. There was a medicine fridge in the clinical room on the second floor and nurses were recording minimum and maximum temperatures. However it was not clear how staff could do that with the thermometer available, as it did not give a minimum and maximum reading. The inspector noted that staff on one of the units were using an inappropriate lancing device to draw blood for blood sugar testing. The information contained in the Medical Device Alert, MDA/2004/044 about lancing devices were not being followed. It is imperative that the right lancing devices are used to prevent cross-infection and to prevent needle-stick injuries. The inspector’s other observations are: • • The instructions on creams were not always clear about the location for using the creams. An antibiotic was being given three times a day at 8:00am, 1:00pm and 6:00pm. This interval meant that the service user went through a period of 14 hours before the next dose was given. The registered person must ensure that medicines are given at a more regular interval to ensure a constant serum level of the medicine as far as possible. Some medications were not recorded when received. • Service users were appropriately dressed, groomed and shaved. Personal care was offered to service users in their bedrooms or in the bathrooms. Service users who were able to express themselves said that they are attended to by staff in an appropriate and sensitive manner. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 12 The manager stated that the home has now acquired a cordless phone to enable service users receive and make calls from their bedrooms. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-15 The home could have done more to ensure that the range of leisure and recreational activities provided by the home was suitable to meet the preferences and expectations of the service users in the home. Meals provided by the home were in general presented in an appealing manner and were suitable to meet the needs of the service users. EVIDENCE: At the time of the inspection the home had a vacancy for an activities coordinator post. Therefore care staff were mostly responsible to provide the activities for service users. The manager stated that at times one of the carers undertook the job of activities coordinator. There was a yearly plan of activities on notice boards. This dealt mostly with external entertainers who have been booked to visit the home. The inspector noted that service users and staff were watching the Wimbledon Tennis Championship at the time. He observed little interaction between staff and service users as most staff were sitting separately from service users. The home caters for a number of service users requiring respite care. They are normally more able than other service users. A number of them who spoke to the inspector said that they do not always mix with the other service users, as they do not have the same needs as the permanent residents and that there is little to stimulate and interest them. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 14 Of the four care records inspected one had a life history and included a completed section on social and recreational activities. There were some cases where service users did not have close representatives to give information about the recreational and social needs of service users. In other cases the assessment of the placement authorities may have information about the past of service users, which may be used to complete some aspects of the social and recreational assessment. As a result the registered person must ensure that as far as possible all service users have a social and recreational needs assessment, with a note being made where this is not possible. The home has an open visiting policy and the inspector observed a number of visitors to the home. Those spoken to by the inspector said that they are made to feel welcome and to be involved in the care of their relatives. Some took the service users out in the garden and others took their relatives for walks around the home. The inspector saw a notice that a representative of the local church visits the home monthly to offer communion. The home has a mini-bus, which is used for outings. The inspector noted that service users, who were able to, were encouraged to make choices about their meals and about whether they wanted to stay in their room or to go to the communal areas. Service users who were able to express themselves stated that they were encouraged to do things for themselves and that they were offered help where necessary in a sensitive manner. The inspector observed on the day of the inspection that the service users who could not express themselves or able to feed themselves were being assisted appropriately. The inspector observed lunch being served in the home on the second floor. There was Toad in a Hole, swede, peas and potatoes as the main meal and lamb cutlets as the second choice. The inspector noted that other meals, which were not on the menu, were also prepared according to service users’ choices. Meals were appropriately presented to service users who sat in the dining room. The dining room and dining tables was prepared appropriately to produce a conducing environment for meals. The inspector after speaking to a number of service users, staff and visitors concluded that the meals provided for service users were generally appropriate to meet their needs. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and18 The home has systems in place to facilitate service users and their representatives express their concerns in the knowledge that these will be taken seriously and acted upon. Allegations and suspicions of abuse in the home are taken seriously and are dealt with appropriately. EVIDENCE: The complaint procedure is available in the foyer of the home. A copy is also provided in the service users’ guide which is offered to all service users. In the past the home has dealt with most complaints appropriately. Since the last inspection the commission has received a complaint, which was partly substantiated. The home has an up to date policy with regard to the protection of vulnerable adults. The manager stated that nearly all of the care staff have had training on abuse issues. In the past allegations and suspicions of abuse have been dealt with, in an appropriate manner. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26 While service users were generally safe and comfortable in the home, some areas, particularly the bedrooms of service users were not always as clean, tidy and in a good decorative state as could have been possible. EVIDENCE: The home is found in a leafy area of Sudbury served by main roads. It is easily accessible by buses, which pass in front of the home. There is a large car park in front of the home. There are some local shops about five minutes walk away from the home. Extensive shopping facilities and more local amenities can be found in Harrow, a 5-10 minutes drive away. The exterior of the home consisted of lawn areas and shrubs, which were maintained. The building also looked in appropriate condition. Internally, some areas were in a better decorative state than others. A decoration and refurbishment plan was provided to the inspector addressing areas, which require redecoration and fittings and fixtures which require replacing. The communal areas were appropriately furnished and were generally clean. The old armchairs have now been replaced and most service users were seated Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 17 comfortably. Other service users had recliner chairs or special chairs to meet their needs. The inspector looked at a number of bedrooms. He noted that there are no locks on the bedrooms’ doors, to enable service users to lock their rooms as per sub-standard 24.5. He also observed that a number of bedrooms, particularly on the second floor have not been redecorated most likely from the inception of the home. A service user who has been in the home for about five years and a visitor whose relative has also been in the home for about the same length of time stated that the bedrooms have not been redecorated since they have been in the home. The decorative state of some of the bedrooms on the second floor indeed looked dated. One of the bedrooms, which has been recently redecorated after a number of requirements to the home, was not decorated thoroughly. Three of the four walls have been painted and the wallpaper on one of the wall was left intact. To ensure that the bedrooms of service users are appropriate to meet the needs of the service users, the registered person must ensure that all the bedrooms of service users are decorated to a high standard. The inspector noted that there were a number of adjustable beds for service users. He however observed that a few service users requiring nursing did not have an adjustable bed and some who had pressure relief equipment did not always have adjustable beds. Some of the beds were placed against the wall and did not allow access to carers on either side of the bed. The inspector noted that some bed lockers were stained with drinks/food spillages. He observed that the lower part of a divan bed in one of the bedrooms was also stained with spillages; that the wall of a bedroom was stained with spillages; and that the carpet was stained/dirty in at least two bedrooms. The inspector also observed that the linoleum in one of the bathrooms was coming off. The flooring in some of the bathrooms was described by a few service users/visitors as not very clean. In one of the bedrooms an unused pressure relief overlay was found in the corner of the bedroom, giving an appearance of untidiness. As a result of the above, the registered person must ensure that the bedrooms of service users are kept tidy and clean at all times. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The home provides staff in sufficient numbers to meet the needs of the service users. EVIDENCE: The home had appropriate numbers of staff on the day of the inspection. The manager informed the inspector that most of the vacant posts in the home have been filled and that the home now rarely uses any agency staff. She added that the home was now stable and that staff could concentrate on giving the appropriate care to service users. The inspector indeed noted a number of familiar members of staff who were aware of the needs of the service users that they looked after. Service users who could express themselves commented on staff providing the appropriate support for them. The manager stated that there were 2 members of staff qualified to NVQ level 3, four have completed NVQ level 2 and 6 were in the process of studying for the NVQ level 2. Taking into consideration that the home has about 30 carers, at this rate it is unlikely that the home would have 50 of carers trained to NVQ level 2 by the end of 2005. Induction and foundation care packages were being provided for new care staff. A training programme of what was considered mandatory training was provided to the inspector. During the inspection, the inspector was also informed of work on the training plan and individual training profiles of staff. The inspector did not see these documents on the day and will view them more comprehensively during the next inspection. He concluded that the manager Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 19 and her staff consider training as an important aspect in securing improvement of the service. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 37 and 38 The manager is not registered yet. She is familiar with issues in the home and seems to be firmly in control. Issues with regard to health and safety were not always addressed comprehensively to ensure the safety of service users at all times. EVIDENCE: The manager has now been in post for about 8 months. She has not been registered yet, but she stated that she has handed in her application. It is important that this process is completed as soon as possible to ensure that she undergoes the necessary process of checking for fitness as per Regulation 9 of the Care Homes Regulations 2001. Conversation with her showed that she was aware of the issues in the home and that she knew the service users and staff well. The inspector noted that she kept a presence on the floors and that she asked about and checked the wellbeing of service users. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 21 The home has nursing stations on each floor. Care records are kept on shelves at the nursing stations. These could be easily accessible to third parties standing at the nursing station while staff are busy attending to their duties I other areas of the floor. As a result the registered person must ensure that all care records are kept securely in the home. During his tour of the premises, the inspector noted that gates to prevent/restrict access to the kitchenettes areas were not very secure and that one of the Domestic rooms was left open. These issues have been raised in past requirements, which have been repeated a number of times and have not been met. The manager in response said that she has contacted a company to fix new gates to these areas and that she would inform the Commission after completion of these works. This was indeed identified in the redecoration plan. During the last inspection there was a requirement with regard to providing a comprehensive Health and Safety risk assessment and a Fire risk assessment. The Health and Safety risk assessment was generally appropriate but the fire risk assessment needed to be made more comprehensive, with regard to not only identifying all the fire risks in the home but also identifying steps to manage the risks to acceptable levels. The inspector noted that a number of service users were using wheelchairs, which did not have footrests and others, which did not have a chair cushion. This issue has been the subject of a past requirement. Failure to address this issue may continue to put service users at risk. The registered person must ensure that appropriate wheelchairs are in use at all times with service users. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 x 2 STAFFING Standard No Score 27 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x x x 2 2 Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1,2) Requirement The registered person must ensure that all service users have a comprehensive record of the assessment of their needs (Previous RequirementTimescale 30/4/5 not met). There must be a care plan in place when a problem has been identified or when a particular intervention is needed from care staff with regard to meeting a service user’s need (Previous Requirement-Timescale 30/4/5 not met). The registered person must ensure that the content of care plans and risk assessments are updated as and when the condition of service users changes. The care plan must be drawn with the service user/representative, agreed and signed by the service user whenever possible and /or representative (if any). A note must be made if this is not possible (Previous RequirementTimescale 30/4/5 not met). Care plans on incontinence or incontinence assessments must Timescale for action 30/9/5 2. OP7 17(1)(a), Schedule 3, (3)(m) 30/9/5 3. OP7 15(2)(b) 30/9/5 4. OP7 15(2)(c) 31/10/5 5. OP8 15(1) 30/9/5 Page 24 Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 6. OP9 13(2,4) 7. OP9 13(2,4) 8. OP9 13(2,4) 9. OP9 13(2,4) 10. OP12 16(2) (m,n) 11. OP24 23(2)(d) 12. OP24 23(2)(n) make clear the actions to take to manage the incontinence including the type of incontinence aids and the timing for their change The registered person must ensure that all medicines received in the home are recorded as appropriate and that the instructions on the labels of creams/lotions are clear about the application of these. The registered person must ensure that appropriate thermometers are in use for the monitoring of the fridge temperatures and that nurses are clear about how to use them. The registered person must ensure that the right lancing devices are being used at all times to draw blood for sampling blood sugar level. The registered person must ensure that medicines are given at a regular interval as far as possible to ensure a constant serum level of the medicines. The registered person must ensure that as far as possible all service users have a social and recreational needs assessment, with a note being made where this is not possible. When arranging for activities the registered person must ensure that the interests and needs of individual service users are taken into consideration as far as possible (Previous RequirementTimescale 30/4/5 not met).. The registered person must ensure that all the bedrooms of service users are decorated to a high standard. The registered person must consider providing adjustable beds to all service users with 30/9/5 30/9/5 30/9/5 30/9/5 31/10/5 31/12/5 31/12/5 Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 25 nursing needs. 13. OP26 23(2)(d) The registered person must ensure that all areas of the home including bedrooms (en-suite, carpets, furniture etc.) are clean and tidy at all times. The registered person must ensure that 50 of care staff are trained to at least NVQ level 2 as soon as possible. The home must have a registered manager as soon as possible. The registered person must ensure that all care records are kept securely in the home and only accessible to staff. All wheelchairs used for the transfer of service users must have seat cushions and footrests unless there has been a risk assessment with regard to the use of footrests (Previous Requirement-Timescale 30/4/5 not met). The home must have a comprehensive fire risk assessments (Previous Requirement-Timescale 30/4/5 not met). The registered person must ensure that the gates to the kitchenettes are maintained in a good state of repair so that they fulfil the function for what they were designed for. She must also ensure that the domestic room is kept locked at all times (Previous RequirementTimescale 30/4/5 not met). 30/9/5 14. OP28 18(1)(c) 31/12/5 15. 16. OP31 OP37 9 17(1)(b) 31/10/5 30/9/5 17. OP38 13(4) 30/9/5 18. OP38 23(4) 30/9/5 19. OP38 13(4) 30/9/5 Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP24 Good Practice Recommendations The registered person should ensure that all bedrooms of service users are personalised to a high level. Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 4th Floor, Aspect Gate 166 College Road Harrow, Middlesex HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Buchanan Court Nursing Home G62-G11 S22918 Buchanan Court V236769 280605 Stage 4.doc Version 1.40 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!